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General NPI Number Information
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NPI Number | 1891499414
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Entity Type | Organization
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Legal Business Name | MINDFUL EMBRACE PLLC
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 17710 NW 13TH CT
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4626
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Country | US
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Telephone | 410-205-9638
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 680353
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City | MIAMI
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State | FL
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Zip | 33168-0353
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIETTE DIXON
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Credential |
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Telephone | 410-205-9638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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